World TB Day has come and gone, but the high rate of tuberculosis among First Nations, Inuit and Métis citizens remains.
Assembly of First Nations National Chief Shawn A-in-chut Atleo marked the World TB Day on March 24 by urging the federal government to use Australia’s Close the Gap campaign as a model to improve the health and quality of life of Canada’s indigenous peoples.
“As First Nations work to address the inequities in health, health care and health services between First Nations and other Canadians, it’s important to look at the overall factors in the health and safety of our peoples,” Atleo said. “Australia’s Close the Gap campaign is a good example of governments working in partnership with indigenous peoples to address a wide range of immediate and long-term needs.”
Australia celebrates World TB Day as Close the Gap Day to mark the 2008 anniversary of an agreement forged between the Australian government and indigenous peoples with support from their coalition partners in the nonprofit health advocacy community and from the public. According to Oxfam, the government committed to take action to achieve indigenous health equality with the non-indigenous society within 25 years by:
- Increasing aboriginal and Torres Strait Islanders’ access to health services
- Addressing critical social issues such as poor housing, nutrition, employment and education
- Building indigenous control and participation in the delivery of health and other services
- Getting governments at state and national level to work in partnership with indigenous communities and indigenous health organizations and expert to develop and monitor a plan to tackle the indigenous health crisis
The initiative identifies $1.6 billion over five years to address the health inequities between the two peoples and it has helped spark additional agreements in the areas of housing, early childhood development, indigenous economic participation and remote service delivery.
While World TB Day is designed to build public awareness of the threat of tuberculosis across the globe—several million people die each year from the disease—health inequities between the indigenous and non-indigenous peoples in Canada are sky high, including rates of tuberculosis. While the disease is more commonly associated with conditions found in developing countries, the Public Health Agency of Canada released figures in 2008 showing that national rates of tuberculosis among First Nations are 31 times higher than other people born in Canada.
“The high rate of tuberculosis in First Nation communities is a clear and stark illustration of the poor living conditions facing too many First Nation men, women and children. The fact we suffer this disease at a rate 31 times the Canadian average is shocking, but it is a direct result of things like overcrowded housing, poor nutrition, unsafe drinking water and a lack of access to health services,” Atleo said.
The news is even worse in the far north. Nunavut’s tuberculosis rate is 62 times the national average, with more than 100 active cases diagnosed in 2010, up from 58 in 2008. This record-breaking year had territorial, federal and health officials calling TB the territory’s most pressing public health issue, and on January 13 the federal government stepped in and announced $800,000 for a public outreach, education, diagnosis and treatment program.
“It’s an important public health issue that’s been lingering for far too long,” said Tagak Curley, Nunavut’s health minister, according to the Nunatsiaq News.
The Nunavut program is called Taima TB, which means “Stop TB” in Inuktitut, and is a partnership of several entities, including the territorial minister of health, Inuit leaders and people from academia and the community.
“By providing financial support to the Taima TB project, we are partnering with the people of Nunavut to combat this deadly but curable disease,” said Health Minister Leona Aglukkaq at the press briefing in Iqaluit.
TB rates among American Indians/Alaska Natives are relatively low by contrast to the First Nations. From 1993 to 2008, the rate of TB among AI/AN declined from 14 to six per 100,000 population, although it is still much higher compared with the rate among whites, one per 100,000, according to the Center for Disease Control and Prevention. In the U.S., Asians had the highest TB case rate at 26 cases per 100,000, which was a slight decrease from 27 in 2007. In 2008, Native Hawaiians or Other Pacific Islanders had the second-highest TB case rate at 16 cases per 100,000, which is a marked decrease compared to 22 cases per 100,000 reported in 2007.
Atleo said the AFN is continuing to identify opportunities and make recommendations for improved and equitable health care and health services for First Nations, particularly now that the renewal discussions for the 2004 Health Accord, a 10-year plan to strengthen health care, have begun. The current joint Health Accord is set for 2014.